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March 1, 2021

Clean Eating’s Dirty Secret 

Clean Eating’s Dirty Secret 

March is National Nutrition Month. For those of us who are dietitians and nutritionists, National Nutrition Month is typically a time to ask folks to think a bit more about food, nutrition, healthy eating, etc. So, it might be a little odd that I am choosing to write about the possible dangers of paying too much attention to the food you eat! 

Don’t get me wrong, I absolutely believe that what you eat—when, how, and with whom you eat—can make a tremendous difference in your physical and mental health, as well as your overall enjoyment of life. However, we are seeing a disturbing trend, particularly online, that promotes strict adherence to a rigid set of food rules as the path to health and moral purity. This is the world of “clean eating.” 

The concept of “eating clean” has its origins in the early days of alternative medicine. People would become obsessed with obtaining health and curing disease through the strident adherence to various dietary strategies. Dr. Steven Bratman, an alternative medicine physician at the time, noted that many of his more diet-focused patients were “inadvertently harming themselves psychologically through excessive focus on food.” Also, their “exuberant pursuit of physical health had spawned a rigid, fearful and self-punishing lifestyle that caused more harm than good.” He created a name for this hyperfocus on food and obsession with eating the “right” food—“Orthorexia Nervosa” (1).

Today when you hear the term “clean eating,” you might think of minimally processed, preferably organic foods, and the avoidance of food additives, preservatives, etc. There is nothing inherently wrong with this, at least not until it starts to become a rigid, life-interfering preoccupation that causes people to feel great distress, shame, and “unclean” if not followed precisely. In such cases, well-intended food choices can reach a “tipping point.” Good intentions go bad, sending people down the path to increased focus and reliance on inflexible eating habits that can result in disordered eating or even an eating disorder.  

Food fads on social media often go to greater and greater extremes in order to grab our attention and maintain it. What we are seeing now is “clean eating” used to describe an increasing variety of food restrictions that can include avoiding all processed foods, sugar, soy, peanuts, dairy, red meat, nightshade vegetables (e.g., tomatoes, bell peppers), caffeine, gluten, and alcohol. 

Starting to sound like an eating disorder? You bet. Obsessing about every detail of what is or isn’t eaten, continually limiting of allowed foods, and spending high percentages of one’s waking hours focusing on food and eating are all hallmarks of disordered eating and eating disorders. Research shows that this can lead to an obsessional or pathological preoccupation with healthy nutrition with serious physical and emotional consequences brought on by non-adherence to self-imposed nutritional rules (2).  

It is important that individuals with eating disorders pay attention to recovery-focused food and eating patterns, making sure meal plan requirements are met, seeking out variety, practicing flexibility, and accepting feared foods. Let’s focus our National Nutrition Month on balance, variety, and moderation, the time-honored advice from your friendly Registered Dietitian—and let “clean eating” simply mean washing our vegetables.


  1. Bratman, Steven, Eat Weight Disord (2017) 22:381-385
  2. Cena H, Barthels F, Cuzzolaro M, Bratman S, Brytek-Matera A, Dunn T, Varga M, Missbach B, Donini LM. Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eat Weight Disord. 2019 Apr;24(2):209-246. doi: 10.1007/s40519-018-0606-y. Epub 2018 Nov 9. PMID: 30414078.


Hilmar Wagner

Hilmar Wagner, MPH, RDN, CD

Hilmar Wagner is a Registered Dietitian/Nutritionist (RDN) and Certified Dietitian (CD) in the state of Washington. Hilmar joined the Emily Program in 2006, and currently serves as the Training Coordinator for Nutrition Services and Clinical Outreach Specialist. In this role he initiates and coordinates training of new dietetic staff, dietetic interns and continuing education for nutrition services for all Emily Program locations. He has presented on a wide range of nutrition topics at local, regional and national conferences. Hilmar received his Bachelor’s degree in Nutrition/Dietetics and Master’s in Public Health Nutrition from the University of Minnesota. He has worked in the field of eating disorders for the past 12 years. Hilmar has extensive experience working with clients of all eating disorder diagnoses in both individual and group settings. He has a particular interest in mindfulness and body-centered approaches to eating disorder recovery.

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